Objective To assess the mid-term and long-term efficacy of the permanent inferior vena cava filter in the treatment of deep vein thrombosis of lower limb and discuss the clinical significance of inferior vena cava filter.Methods Retrospectively analyze on the 86 cases with deep vein thrombosis of lower limb (41 males and 45 females,aged 50 to 94 years,mean age was 71.8 years) treated with implantation of permanent inferior vena cava filter in inferior vena cava from Janunary 2010 to October 2015.In these patients,there were 51 cases with embolism in the left leg,25 cases in the right leg,10 cases in both legs and 6 cases were accompanied with pulmonary embolism.The cases without contraindication underwent catheter directed thrombolysis and even percutaneous transluminal angioplasty or stents subsequently if necessary after inferior vena cava filter implantation.All the cases with no contraindication were treated with anticoagulant therapy.Results All the 86 patients were implanted inferior vena cava filter (B.Braun Vena Tech LP 76 and Cordis TrapEase 10)successfully.Sisty-five cases were underwent inferior wena cava filter implantation only,while 21 cases were treated with inferior vena cava filter implantation and catheter directed thrombolysis or even percutaneous transluminal angioplasty and stents.During the follow-up period(12 to 81 months,mean time was 51 months),27 patients died dueing to malignant tumor(17 cases) and other diseases (10 cases) rather than complications caused by inferior vena cava filter.Three patients had recurrence of deep vein thrombosis and 2 patients suffered from the thrombosis induced by stenosis of stents.Inferior vena cava filter appered tilted with angle less than 15 degrees in 6 cases.Three cases suffered from new thrombosis below the filter and 2 cases complained of the filter migration.No case was found with fracture of filter,perforation of the inferior vena cava,bleeding or pulmonary embolism(new onset or recurrent).Conclusions Application of permanent inferior vena cava filter may cause complications,though it is an effective approach to prevent pulmonary embolism in patients with deep vein thrombosis of lower limb.However,permanent inferior vena cava filter may be fit for patients with old age,incurable cancer or limited expected life.

Objective To summarize clinical experience of one-station therapy for infected seriouslyischemic diabetic foot.Methods The clinical data of 15 patients (15 diseased limbs in total) with infected seriously-ischemic diabetic foot,who were admitted to authors' hospital during the period from June 2015 to April 2016 to receive treatment,were retrospectively analyzed.For all patients,one-station sequential therapy was carried out,which included endovascular revascularization (EVR) to open occluded vessel,surgical debridement and closed negative pressure wound drainage and antiseptic moisturizing wound dressing.The healing rate of infected wound and the limb salvage rate were evaluated.Results The 15 patients included 10 males and 5 females,with a median age of 77 years old.Lower extremity angiography showed that multiple segmental lesions of lower limb were detected in 13 patients and simple leg lesions in 2 patients.According to TASC Ⅱ update classification,leg artery disease of grade D was observed in 13 patients and artery disease of grade C in 2 patients.After EVR therapy,at least one branch of leg arteries was reopened in 14 limbs.Intact arterial arch of pedal-plantar loop (PPL) was seen in 6 patients,semi-arterial arch in 7 patients,and absent of arterial arch in 2 patients.After surgical debridement,the wound was washed by using negative pressure wound therapy (NPWT) device as well as serf-made washing equipment.The time to control wound infection was (7.85±2.84) days.After discharge,the patients were followed up every 3-4 days,at the same time wound dressing exchange with antibacterial moisturizing sulfadiazine silver lipid hydrogel was conducted.Wound healing was achieved in 12 patients,and the mean healing time was (3.70±0.87) months.The wound failed to heal in 3 patients,among them below knee amputation had to be performed in 2 patients (13.3％,both patients showed absent of arterial arch of PPL),and the remaining one patient died of cardiovascular event.Statistically significant difference in PPL pathological changes existed between wound healing group and wound un-healing group (P=0.006 7).Conclusion The treatment of infected seriouslyischemic diabetic foot is rather complicated.Being one-station therapy,the sequential managements,which include EVR,NPWT device together with washing equipment and use of antibacterial moisturizing wound dressing,can effectively increase the blood supply to the affected limb,shorten the time to control infection and lower amputation rate.Therefore,one-station therapy should be regarded as the preferred method for infected seriously-ischemic diabetic foot.

Objective: To study the effect of a potent angiogenic in hi bitor TNP-470 on the growth of sarcoma. Methods:1?10 6 sarcom a S-180 cells 0.1 ml were inoculated into submandibular region in each of 40 K M mice. The mice were divided into control and treatment groups with 10 in each group. Treatment was started 8 hours after inoculation. TNP-40 at 10 mg/kg, 30 mg/kg and 100 mg/kg was given subcutaneously every other day in the 3 treatment groups,total 6 times. On the 12th day, the mice were sacrificed, tumor and mice were weighted. Apoptosis of tumor cells was observed by TUNEL method and transmi ssion microscope. Express of VEGF, bFGF were detected by immunohistochemical sta ining. Results:Sarcoma was developed in all of the mice. The sa rcoma cells invaded deep into adjacent organs and tissues such as muscle, subman dibular gland, parotid and facial nerve. 10 mg/kg, 30 mg/kg and 100 mg/kg TNP- 470 inhibited the growth of the tumor by 27.62%,63.81% and 85.71% respective ly, increased the apoptosis cell number by 54.46%,156.69% and 432.48% respect ively (P

BACKGROUND:Study shows that margarita liquid has effect on promoting histiocyte regeneration and removing scars.OBJECTIVE:To observe the effects of margarita liquid on the proliferation of fibroblasts in human skin scar tissues.DESIGN,TIME AND SETTING:A grouping contrast observational experiment was performed in the Experiment Centre of Guangxi Medical University from September to December in 2008.MATERIALS:Scar tissue samples were obtained from patients in the Department of Plastic Surgery,Guangxi Medical University.Margarita liquid was the digest of margarita purchased from Beihai Gofar Marine Biological Industry Co.,Ltd and rich in multi-amino acids,polypeptides,vitamin,mineral matters and natural enzymes.METHODS:Human skin scar cell line was established by removing non-fibroblasts through repeated primary culture and serial subcultivation of scar fibroblasts with reference to Veelken method. The 3-5 generation human skin scar fibroblasts on exponential phase of growth were made into single cell suspension by trypsin digestion which was then inoculated on plastic 96-well cell culture plate,with the density of 0.5×10~4/well as well as 100 μL cell suspension and 100 μL DMEM medium in each well. After culture for 24 hours,primary medium was discarded. The grouping of the experiment:200 μL mediums with 125.00,62.50,31.30,15.60,7.80,3.90,1.95,0.98 mg/L margarita liquid were used respectively in margarita liquid group;200 μL pure medium was added into each well in control group.MAIN OUTCOME MEASURES:MTT and TUNEL assay were used to examine the proliferation and the apoptosis of fibroblastsrespectively.RESULTS:The 50% inhibiting concentration (IC_(50)) of margarita liquid on fibroblasts was 15 mg/L. Margarita liquid at any other concentration but 0.98 mg/L was effective in inhibiting fibroblast growth in a dose-dependent way,i.e. the higher margarita liquidconcentration,the higher inhibition ratio on fibroblast growth. Fibroblasts cultured with 15 mg/L (IC_(50)50) margarita liquid had got reduced volume,lessened cytoplasm,decreased density,increased apoptosis rate and buffy colour. Fibroblasts in control group were large,rich in cytoplasm and compact. Apoptotic index was higher in the margarita liquid group than in the blank control group CONCLUSION:Margarita liquid could inhibit the proliferation of skin scar fibroblasts cultured in vitro and induce the apoptosis of them.

Objective To evaluate the preventive and therapeutic effects of artemisinin and artesunate on hypertrophic scar in rabbit ears.Methods Full-thickness wounds to cartilage were created in New Zealand white rabbit cars to establish animal models of hypertrophic scar.Cream was prepared with artemisinin or artesunate.A total of 96 hypertrophic scars were divided into 4 groups to receive the treatment with artemisinin cream.artesunate cream.cream vehicle(vehicle control)or no treatment(blank control)28 days after wounds were created.After 28-day treatment,animals were scarified,scars were incised and examined with HE-staining and VG-staining.Hypertrophy index.numerical density of fibroblasts and area density of collagen fibers were calculated.Results Compared with vehicle and blank controls,the scars were softer and flatter,the volume of fibroblasts decreased,and collagen fibers appeared to be more regulated and sparse in artemisiIlin or artesunate cream-treated groups.The Hypertrophy index.numerical density of fibroblasts.area density of collagen fibers were(1.452±0.27),(3638.245±463.0)cells/mm2,(32.29±6.9)%in artemisinin cream-treated group,respectively,(1.445±0.24),(3585.016±638.9)cells/mm2,(34.74±8.27)%in artesunate cream-treated group,respectively.All the three parameters were significantly reduced in artemisinin and artesunate groups than in blank and vehicle control groups(all P＜0.0 1).but no significant difference was found between artemisinin and artesunate groups (P＞0.05).Conclusion Artemisinin and artestmate cream has a reliable efficacy in the prevention and treatment of hypertrophic scar in animal models.

Objective To analyze the clinical effect of infrapopliteal arteries revascularization in patients with limb ischemic ulcer.Methods Clinical data of 152 patients (152 legs) suffering from CLI ischemic ulcer from June 2011 to June 2013 undergoing arterial revascularization using angiosome concept were retrospectively reviewed.Patients were grouped according to runoff,WB angiography,the number of outflow,angiosome model of revascularization and quality of pedal arch.Results Reintervention or ampatation (RAO) rate within 12 months was higher in runoff 0 group that in runoff ＞ 1 group (P ＜ 0.05)and runoff 1 (P ＜0.05).WB (+) group vs WB (-) group of RAO rate within 12 months,ulcer healing rate within 12 months showed no statistical difference.Limb salvage rate within 18 months was higher in WB (+) group than that in WB (-) group (P ＜0.05).Ulcer healing rate within 12 months and limb salvage · rate 18 months in group IRw was lower than group DR (P ＜ 0.05) and group IRc(P ＜ 0.05).RAO rate within 12 month rate was higher in IRw group than in DR group (P ＜ 0.05) and group IRe (P ＜ 0.05).Ulcer healing rate within 12 months and limb salvage rate within 18 months in group NPA was lower than group CPA (P ＜ 0.05) and group IPA (P ＜ 0.05).RAO rate within 12 month rate was higher in NPA group than in CPA group (P ＜ 0.05) and group IPA (P ＜ 0.05).Conclusion The rate of limb salvage was higher in WB (+).IRc revascularization has similar outcome with DR revascularization in ulcer healing rate and limb salvage rate.Clinical effect of CPA and IPA are better than NPA.

Objective To evaluate the feasibility and safety of using bidirectional subintimal technique,i.e.subintimal arterial flossing with antegrade-retrograde intervention (SAFARI),in endovascular treatment of subclavian arterial occlusion when the guide wire cannot re-enter into the distal true cavity.Methods The clinical data of 11 patients with symptomatic subclavian artery occlusion,who were admitted to authors' hospital during the period from August 2013 to June 2016 to receive treatment,were retrospectively analyzed.The patients included 8 males and 3 females,with a mean age of 67 years old (61-74 years).Endovascular recanalization of subclavian artery with SAFARI technique and stent implantation were carried out in all patients after conventional reopening surgery of obstructed artery failed.Results Subclavian artery recanalization by using SAFARI technique together with implantation of stent (average length of 46.4 mm) was successfully accomplished in 10 patients,but in one patient the technical management failed,the technical success rate was 90.9％.No serious postoperative complications occurred.The patients were followed up for 6-36 months by telephone,and no in-stent restenosis was verified during the follow-up period.Conclusion In treating severely calcified and long-segmental subclavian artery occlusion,endovascular treatment using SAFARI technique is safe and effective,SAFARI technique can further improve the success rate of endovascular treatment.

Objective To evaluate the clinical effect of endovascular therapy with covered stent in treating aortoiliac occlusive disease. Methods The clinical data of 20 patients with aortoiliac occlusive disease, who received endovascular therapy with covered stent during the period from January 2014 to December 2016, were collected. According to Rutherford standard of clinical symptom classification, gradeⅢ, grade Ⅳ and grade V were seen in 9, 7 and 4 patients respectively. Based on the Trans-Atlantic Society Coalition (TASC) treatment guidelines Ⅱ classification, B type, C type and D type were observed in 4, 7 and 9 patients respectively. The postoperative primary patency and secondary patency of the stent as well as the clinical efficacy were analyzed. Results Endovascular treatment was successfully accomplished in all 20 patients. After the treatment, the clinical symptoms were significantly relieved. Two patients developed complications (10％). One patient developed thrombus at the distal end of stent, which was improved after thrombolytic therapy. Another patient developed hematoma at puncture site, which was absorbed after conservative therapy. No perioperative death occurred. The patients were followed up for 5-37 months, with a mean of (17±10) months. The primary patency rate was 95％ and the secondary patency rate was 100％. Conclusion For the treatment of aortoiliac occlusive disease, endovascular therapy with covered stent has excellent clinical efficacy.